Pregnancy, Childbirth & Fertility
Episiotomy
A surgical cut in the perineum made during childbirth to widen the vaginal opening, now used selectively rather than routinely, with healing usually well underway within two to four weeks.
Also known as: Perineal Incision, Episiotomy Recovery, Perineotomy
📝 At a glance
Likely root causes: A clinical decision during birth to widen the vaginal opening quickly, often for fetal distress or to assist an instrumental delivery; Concern that a spontaneous tear may extend further without a controlled cut; Use of forceps or vacuum extraction, which more often calls for an episiotomy.
First thing to try: CAUTION -- Seek same-day medical review if pain is increasing rather than easing, if there is foul-smelling discharge, fever, the wound gaping or feeling as though it has come apart, pus, difficulty passing urine or stool, or any new incontinence of wind or stool -- that last sign in particular needs urgent referral and should never be dismissed as ordinary postpartum change.
See a doctor if: Pain that is getting worse instead of better, or spreads beyond the wound area
🔎 Start with the cause
Lasting relief rarely comes from covering a symptom. First find what is feeding the problem, change what you can, and then help the body do what it was designed to do — heal.
Likely root causes
- A clinical decision during birth to widen the vaginal opening quickly, often for fetal distress or to assist an instrumental delivery
- Concern that a spontaneous tear may extend further without a controlled cut
- Use of forceps or vacuum extraction, which more often calls for an episiotomy
- A large baby, a fast second stage of labour, or a baby in an awkward position
- First-time vaginal birth, where the perineal tissue has not stretched before
- Rigid or less elastic perineal tissue that does not stretch easily under pressure
Change what you can
- CAUTION -- Seek same-day medical review if pain is increasing rather than easing, if there is foul-smelling discharge, fever, the wound gaping or feeling as though it has come apart, pus, difficulty passing urine or stool, or any new incontinence of wind or stool -- that last sign in particular needs urgent referral and should never be dismissed as ordinary postpartum change.
- Apply a cold compressA cloth soaked in warm or cold liquid, held on the skin. How to make a compress → or gelA cool, jelly-like preparation that soothes and moisturizes skin. How to make a gel → pack wrapped in a cloth to the perineum for the first 24 to 48 hours to reduce swelling and numb soreness
- Switch to warm, comfortably shallow sitz baths (around 40 C / 104 F, never hot) a couple of times a day once the first day or two has passed
- Use a peri-bottle filled with warm water to rinse the area while passing urine, which softens the sting considerably
- Pat the area dry gently from front to back after washing or using the toilet, rather than rubbing
- Wear loose, breathable cotton underwear and change sanitary pads frequently to keep the area clean and dry
- Keep stools soft by eating plenty of fibre, drinking enough fluid, and using a stool softener if a midwife or doctor recommends one -- straining should be avoided altogether
- Start gentle pelvic floor exercises as soon as they feel comfortable, building up gradually rather than pushing through pain
- Sit on a soft cushion or a specially designed ring cushion to take pressure off the stitched area
- Rest when possible and avoid standing or sitting in one position for very long stretches
- Take paracetamol or another recommended pain reliever as needed, checking suitability with a health professional
- If sex remains painful weeks or months later, raise it with a doctor or midwife rather than assuming it must be endured -- there are usually things that can help
🩺 When to see a doctor
- Pain that is getting worse instead of better, or spreads beyond the wound area
- Fever, chills, or a generally unwell feeling alongside perineal pain
- Foul-smelling discharge, pus, or a wound that looks like it has opened
- New difficulty or pain passing urine, or inability to pass urine at all
- Any leaking of wind or stool that was not there before
- Pain during sex that persists well beyond the initial healing period
🌿 The seven pathways to health
Seven pathways for your episiotomy — tap the circle to check one off (saved on your device), or ask Remy for help.
“Disease is an effort of nature to free the system from conditions that result from a violation of the laws of health... In case of sickness 1cause should be ascertained, 2go to work intelligently to remove the disease. 3Unhealthful conditions should be changed, 4wrong habits corrected. 5Then nature is to be assisted in her effort 6to expel impurities and 7to re-establish right conditions in the system.”
🌿 Overview
An episiotomy is a small incision made in the tissue between the vaginal opening and the anus during the final stage of labour, usually to help the baby out more quickly or to avoid a more ragged tear. Practice has shifted a great deal over recent decades: episiotomy was once done routinely, but current guidance favours a selective approach, since a spontaneous tear often heals as well as or better than a surgical cut and carries fewer risks to deep tissue. The stitches used to repair the cut dissolve on their own, and most of the soreness, swelling, and tenderness eases within two to four weeks, though full comfort -- including during sex -- can take longer. Gentle, sensible aftercare makes a real difference to how comfortable this period feels.
What an episiotomy actually is. An episiotomy is a small, deliberate cut made in the perineum -- the tissue between the vaginal opening and the anus -- during the pushing stage of labour, to widen the space the baby passes through. It is done under local anaesthetic where possible and repaired afterward with dissolvable stitches. It is worth knowing that practice has moved away from doing this routinely: most maternity guidelines now recommend a selective approach, reserving episiotomy for specific situations such as fetal distress or an instrumental delivery, because a spontaneous tear frequently heals just as well, sometimes better, and avoids an unnecessary surgical cut.
The healing arc. Most of the acute soreness, swelling, and sensitivity settles within two to four weeks, though the tissue continues to remodel and soften for some months. Everyone's timeline differs a little depending on the extent of the cut, whether it needed extending, and how the stitches take.
Comfort measures that genuinely help. Cold compresses in the first day or two reduce swelling and numb the area; after that, warm shallow sitz baths at a comfortably warm temperature -- never hot -- soothe soreness and keep the area clean. A peri-bottle of warm water used while urinating takes much of the sting away, and patting dry from front to back afterward protects the healing tissue. Loose cotton underwear, frequent pad changes, and a soft cushion to sit on all reduce friction and pressure on the wound.
Protecting the wound from within. Perhaps the most overlooked piece of aftercare is what happens in the bowel: straining against a healing perineal wound is uncomfortable and can genuinely slow healing or cause problems, so keeping stools soft through fibre, fluids, and a stool softener if recommended is a simple, effective form of protection. Gentle pelvic floor exercises, introduced once comfortable, support both healing and long-term continence.
When to ask for help. Pain that worsens instead of easing, fever, foul-smelling discharge, a wound that looks like it has opened, pus, new trouble with urination or bowel movements, or any leaking of wind or stool are all signs that need medical review the same day -- the last of these in particular is a sign of a deeper injury that needs a proper assessment, not something to wait out. Similarly, pain during sex that persists for months after birth is common enough to mention to a doctor or midwife, and there are usually ways to help -- there is no need to simply endure it in silence.
Common signs
- Soreness or stinging around the stitched area, especially in the first week
- Swelling and bruising of the perineum
- Stinging when urine passes over the wound
- Discomfort or a pulling sensation when sitting, walking, or coughing
- Mild itching as the tissue heals
- Tenderness that gradually lessens over two to four weeks
- Occasional twinges or sensitivity at the scar for months afterward
- Pain or apprehension around resuming sexual intercourse
⭐ Community-ranked natural supports
Vote ▲ on everything that helped you, and ▼ on anything you tried that didn't — the ranking updates live. Tap 💬 to share what worked, so others can find it faster.
Drinking enough water throughout the day supports soft stools, healthy circulation for tissue repair, and general recovery energy; it is a supportive habit, not a treatment for infection or pain on its own.1000
Prioritising sleep and rest whenever possible, with help from others for chores and older children, gives the body's own repair processes the time they need; rest will not close a wound faster by itself, but overexertion can genuinely slow healing and worsen swelling.970
A gel pack or ice wrapped in a clean cloth applied to the perineum for short periods in the first day or two after birth; it reduces swelling and numbs surface pain, but should never be applied directly to skin or left on so long it causes tissue damage.940
How the numbers work: this is a weighted voting system — every published book or article recommending a remedy counts as an endorsement vote, and your ▲/▼ counts too. Not medical advice. *Ties are broken by our editor score (sources, safety, simplicity, cost, lifestyle fit, eight-laws alignment).
🍽️ Eating to help
Food is one of the gentlest medicines — small, steady changes help most.
Favor these
- High-fibre foods such as fruit, vegetables, wholegrains, and legumes
- Plenty of water and other fluids
- Lean protein to support tissue repair
- Foods naturally rich in vitamin C, such as citrus and berries, to support healing
Go easy on
- Highly processed, low-fibre foods that make stools harder to pass
- Excess caffeine, which can contribute to dehydration
- Straining-inducing low-fluid eating patterns
Soft, regular, well-hydrated bowel movements are one of the simplest ways to protect a healing perineal wound from unnecessary strain.
⚖️ Good to know
- Never use hot water for sitz baths -- comfortably warm only, around 40 C / 104 F
- Do not resume tampon use, penetrative sex, or high-impact exercise until a health professional confirms the wound has healed
- Avoid scrubbing or rubbing the stitched area -- pat, do not wipe vigorously
- Do not ignore worsening pain in the hope it will pass; infection can develop quickly
- Check that any pain reliever is compatible with breastfeeding before taking it
⚕️ What a doctor may offerConventional treatments for this condition — for your information.Show ▾
RemedyRank's heart is natural healing — and honest information. Here is what conventional medical care commonly involves for this condition, listed to inform, never to promote. Decisions about treatment belong with you and your own physician.
An episiotomy is a small surgical cut made in the perineum during birth to widen the vaginal opening; it is now used selectively rather than routinely, and is repaired with dissolvable stitches soon after delivery.
Commonly offered
- Local anaesthetic and stitching (usually dissolvable sutures) to repair the incision after birth–
- Regular paracetamol and, if needed, an NSAID such as ibuprofen for pain relief–
- Topical local anaesthetic gel or spray for perineal discomfort–
- Antibiotics if the wound becomes infected–
- Referral to a pelvic health physiotherapist for ongoing pain, scarring, or pelvic floor weakness–
Worth knowing
- Do not take more than the recommended dose of over-the-counter painkillers, and check what is safe while breastfeeding
- NSAIDs are not suitable for everyone -- check with a midwife, doctor, or pharmacist first
- Seek medical review promptly if pain increases rather than eases, or if the wound looks infected
- Report any new incontinence of wind or stool straight away rather than waiting for it to settle on its own
👍/👎 shares whether a treatment helped you — community experience, not medical advice. For full professional details, see the sources under “Learn more” below.
📚 Learn more
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